At-home dialysis makes life easier for patients

By Molly McGowan

Published: Saturday, June 29, 2013 at 03:59 PM.

So in 2011, he began undergoing conventional hemodialysis treatments at one of the two DaVita dialysis centers in Burlington. Three times a week, his arterial blood was drawn out of one vein in his right arm and into a hemodialyzer, which cleaned the blood with his prescription cocktail of Dialysate before pumping it back into his body through another vein in his arm.

This January, he switched to homecare hemodialysis, at the suggestion of his nephrologist, Dr. Munsoor Lateef with Central Carolina Kidney Associates.

The local practice works with the two dialysis providers in Alamance County, DaVita and Fresenius Medical Care. He and other home hemodialysis patients visit the DaVita center in Durham bimonthly for medications or adjustments they can’t receive at home.

THOUGH THE process still tires him out, the couple notices a difference in performing the medical treatment at home five days a week as opposed to three days a week at the center.

“A lot of folks at the center, when they go home they go to bed for two hours,” he said. “I just go about my business.”

JoAnn Rich said having hemodialysis only three times a week meant drawing more fluid from her husband over four hours, and he felt exhausted and nauseated by the time he got home. At home, she and their daughter, Susan Jones, clean his blood five days a week during shorter, two-and-a-half-hour sessions.

Max Rich sits in a recliner, connected by two blood-filled tubes to the hemodialysis machine that stands in for his liver.

Just like any other hemodialysis patient, he’s got needles stuck in his arm. The process makes him chilly and tired. But unlike others, he is in the comfort of his own home, watching westerns with his daughter, and doesn’t feel as sick after his almost-daily treatments. That’s why his nephrologist is encouraging more eligible kidney patients to try home dialysis, which he says is growing in popularity.

Rich, 79. lives in Burlington with his wife, JoAnn. He spent 44 years in ministry before his failing health forced him to retire. He founded both Kimesville Road Baptist Church, and most recently founded and preached at Guiding Light Baptist Church in Elon. He retired in 2011, a year after being diagnosed with kidney failure.

“This mess hit me pretty hard,” he said.

With heart and lung problems, he said, “They can patch you up.” But when it comes to the kidneys, there are no quick fixes. He said he’s too old to qualify for a kidney transplant.

“His health wouldn’t permit it even if was 40,” JoAnn Rich added.

She said before the kidney problems, he had already undergone surgery for an aneurism in his leg, battled and beaten both lung and prostate cancer, and had other health problems that knocked him out of the running for a kidney transplant.

So in 2011, he began undergoing conventional hemodialysis treatments at one of the two DaVita dialysis centers in Burlington. Three times a week, his arterial blood was drawn out of one vein in his right arm and into a hemodialyzer, which cleaned the blood with his prescription cocktail of Dialysate before pumping it back into his body through another vein in his arm.

This January, he switched to homecare hemodialysis, at the suggestion of his nephrologist, Dr. Munsoor Lateef with Central Carolina Kidney Associates.

The local practice works with the two dialysis providers in Alamance County, DaVita and Fresenius Medical Care. He and other home hemodialysis patients visit the DaVita center in Durham bimonthly for medications or adjustments they can’t receive at home.

THOUGH THE process still tires him out, the couple notices a difference in performing the medical treatment at home five days a week as opposed to three days a week at the center.

“A lot of folks at the center, when they go home they go to bed for two hours,” he said. “I just go about my business.”

JoAnn Rich said having hemodialysis only three times a week meant drawing more fluid from her husband over four hours, and he felt exhausted and nauseated by the time he got home. At home, she and their daughter, Susan Jones, clean his blood five days a week during shorter, two-and-a-half-hour sessions.

“The fluid (doesn’t) build up as bad, and it’s not as bad on the heart to pull that small amount at a time,” JoAnn Rich said. “It’s less of an overhaul on the system.”

It’s also more convenient at home. No appointment is necessary. Everything is on the patient’s own time. At home, Rich doesn’t have to wait and the portable home dialysis machine means planning his treatment around his life, instead of the other way around.

The couple is planning their first vacation using the in-home dialysis.

“If you go on vacation you take your machine with you, and you clean the blood just like you would at home,” JoAnn Rich said.

But that means lots of planning, including ordering the treatment supplies and having them shipped toward their campground.

“It takes a dedicated partner to do it,” she said. She retired from cosmetology to take care of her husband. Jones also retired after her father’s diagnosis, to help her mother care for him.

“I look forward to coming over here.” she said and asked her father, “What show do we watch, Daddy?”

They watch “The High Chaparral” on TV whenever she gives him his treatment.

“I’ve watched more westerns in the last year than in 30 years,” Jones said.

BOTH JONES and her mother trained at the DaVita center in Durham for months, learning how to hook their patient up to the machine, clean his blood and sanitize everything after the daily procedure.

Though he’s only hooked up for two and a half hours, it takes mother and daughter four hours total to set up the machine, put the tubes in his arms, clean the blood, then sanitize the machine. The two women check his blood pressure every 30 minutes, record his levels and fax the numbers into the DaVita center in Durham.

“It’s a process,” Jones said.

“It’s my place by marriage to look after him,” JoAnn Rich said. “You make a vow. That’s it.”

Lateef said it’s necessary to have that reliable support system if a dialysis patient is going to do the treatment at home.

“Not everybody has that,” he said.

Lateef said he screens his patients who are treated by either of the two local dialysis providers, DaVita or Fresenius Medical Care, for home dialysis. He looks for candidates that have strong family support and have difficulty with conventional in-center dialysis.

To Lateef’s knowledge, Max Rich is the third person in Alamance County to ever receive home hemodialysis, and is only one of two surviving patients doing the at-home treatment.

Lateef said more and more people across the country are on dialysis because they live longer and are at higher risk for their kidneys failing over time. Currently in Alamance County, there are about 250 to 280 dialysis patients.

Lateef said a person’s kidneys are working constantly every day and not just three times a week.

“This (home) therapy is more akin to that, because you’re doing it more often,” than conventional dialysis, he said.

Lateef said the large quantities of salt and water taken from the body during conventional dialysis is what makes the patient feel so exhausted and sick, and phosphorous tends to build up. “We remove that with greater efficiency,” when treatments are done more often, Lateef said.

The trend in North Carolina is to try home dialysis. At the moment, 19 home hemodialysis patients check in with the Durham center twice a month for medication adjustments.